Perinatal Outcome of Monochorionic Twins With Selective IUGR Compared With Uncomplicated Monochorionic Twins

Boaz Weisz; Liat Hogen; Yoav Yinon; Liat Gindes; Alon Shrim; Michal Simchen; Eyal Schiff; Shlomo Lipitz

doi:10.1375/twin.14.5.457

Abstract

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Objective: To evaluate the perinatal outcome of MC twins with selective IUGR (sIUGR).

Study design: A prospective study, which included three groups of MC twins: Group A, uncomplicated MC twin pregnancies (n = 91); group B, sIUGR with normal umbilical artery Doppler (n = 19); and group C, sIUGR with abnormal (absence or reversed EDV) umbilical artery Doppler (n = 18). The latter were routinely hospitalized in the high-risk ward under strict surveillance.

Results: Neonatal outcome of fetuses complicated with sIUGR and normal Doppler was similar to controls. Neonates born to pregnancies complicated by sIUGR and abnormal Doppler had significantly increased incidence of CNS findings, RDS, NEC, sepsis, and neonatal death compared to controls. Adverse outcome in this group was independently associated only with gestational age at birth.

Conclusion: The perinatal outcomes of MC twins complicated with sIUGR and normal Doppler are similar to uncomplicated MC pregnancies. MC twins with sIUGR and abnormal Doppler have reasonable outcomes, yet significantly more neonatal complications compared to non-complicated MC twins.

Crossref Citations

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Lopriore, Enrico Sluimers, Carolien Pasman, Suzanne A. Middeldorp, Johanna M. Oepkes, Dick and Walther, Frans J. 2012. Neonatal Morbidity in Growth-Discordant Monochorionic Twins: Comparison Between the Larger and the Smaller Twin. Twin Research and Human Genetics, Vol. 15, Issue. 4, p. 541.

Danon, David Sekar, Renuka Hack, Karien E. A. and Fisk, Nicholas M. 2013. Increased Stillbirth in Uncomplicated Monochorionic Twin Pregnancies. Obstetrics & Gynecology, Vol. 121, Issue. 6, p. 1318.

Longo, Stefania Borghesi, Alessandro Tzialla, Chryssoula and Stronati, Mauro 2014. IUGR and infections. Early Human Development, Vol. 90, Issue. , p. S42.

Shi, X. He, Z. Gao, Y. Luo, Y. Gou, C. and Fang, Q. 2014. Placental expression of PHLDA2 in selective intrauterine growth restriction in monozygotic twins. Placenta, Vol. 35, Issue. 6, p. 428.

Inklaar, M. J. van Klink, J. M. M. Stolk, T. T. van Zwet, E. W. Oepkes, D. and Lopriore, E. 2014. Cerebral injury in monochorionic twins with selective intrauterine growth restriction: a systematic review. Prenatal Diagnosis, Vol. 34, Issue. 3, p. 205.

Chmait, Ramen H. Chon, Andrew H. Schrager, Sheree M. Kontopoulos, Eftichia V. Quintero, Rubén A. and Vanderbilt, Douglas L. 2015. Donor catch-up growth after laser surgery for twin–twin transfusion syndrome. Early Human Development, Vol. 91, Issue. 12, p. 751.

Emery, Stephen P. Bahtiyar, Mert O. and Moise, Kenneth J. 2015. The North American Fetal Therapy Network Consensus Statement. Obstetrics & Gynecology, Vol. 126, Issue. 3, p. 575.

Khalil, Asma A. Khan, Naila Bowe, Sophie Familiari, Alessandra Papageorghiou, Aris Bhide, Amar and Thilaganathan, Basky 2015. Discordance in fetal biometry and Doppler are independent predictors of the risk of perinatal loss in twin pregnancies. American Journal of Obstetrics and Gynecology, Vol. 213, Issue. 2, p. 222.e1.

Meyer, Michael P. and Alexander, Tanith 2017. Reduction in necrotizing enterocolitis and improved outcomes in preterm infants following routine supplementation with Lactobacillus GG in combination with bovine lactoferrin. Journal of Neonatal-Perinatal Medicine, Vol. 10, Issue. 3, p. 249.

Koch, A. Favre, R. Viville, B. Fritz, G. Kohler, M. Guerra, F. Lecointre, L. Gaudineau, A. Langer, B. Weingertner, A.-S. and Sananès, N. 2017. Expectant management and laser photocoagulation in isolated selective intra-uterine growth restriction: A single-center series. Journal of Gynecology Obstetrics and Human Reproduction, Vol. 46, Issue. 10, p. 731.

Glanc, Phyllis Nyberg, David A. Khati, Nadia J. Deshmukh, Sandeep Prakash Dudiak, Kika M. Henrichsen, Tara Lynn Poder, Liina Shipp, Thomas D. Simpson, Lynn Weber, Therese M. and Zelop, Carolyn M. 2017. ACR Appropriateness Criteria ® Multiple Gestations. Journal of the American College of Radiology, Vol. 14, Issue. 11, p. S476.

Wen, Hong Chen, Lu He, Jing and Lin, Jun 2017. MicroRNA expression profiles and networks in placentas complicated with selective intrauterine growth restriction. Molecular Medicine Reports, Vol. 16, Issue. 5, p. 6650.

Buca, D. Pagani, G. Rizzo, G. Familiari, A. Flacco, M. E. Manzoli, L. Liberati, M. Fanfani, F. Scambia, G. and D'Antonio, F. 2017. Outcome of monochorionic twin pregnancy with selective intrauterine growth restriction according to umbilical artery Doppler flow pattern of smaller twin: systematic review and meta‐analysis. Ultrasound in Obstetrics & Gynecology, Vol. 50, Issue. 5, p. 559.

D'Antonio, F. Odibo, A. O. Prefumo, F. Khalil, A. Buca, D. Flacco, M. E. Liberati, M. Manzoli, L. and Acharya, G. 2018. Weight discordance and perinatal mortality in twin pregnancy: systematic review and meta‐analysis. Ultrasound in Obstetrics & Gynecology, Vol. 52, Issue. 1, p. 11.

Briana, Despina D. and Malamitsi-Puchner, Ariadne 2019. Twins and neurodevelopmental outcomes: the effect of IVF, fetal growth restriction, and preterm birth. The Journal of Maternal-Fetal & Neonatal Medicine, Vol. 32, Issue. 13, p. 2256.

Sileo, F. G. Duffy, J. M. N. Townsend, R. and Khalil, A. 2019. Variation in outcome reporting across studies evaluating interventions for selective fetal growth restriction. Ultrasound in Obstetrics & Gynecology, Vol. 54, Issue. 1, p. 10.

Townsend, R. D'Antonio, F. Sileo, F. G. Kumbay, H. Thilaganathan, B. and Khalil, A. 2019. Perinatal outcome of monochorionic twin pregnancy complicated by selective fetal growth restriction according to management: systematic review and meta‐analysis. Ultrasound in Obstetrics & Gynecology, Vol. 53, Issue. 1, p. 36.

Bæk, Ole Sangild, Per Torp Thymann, Thomas and Nguyen, Duc Ninh 2019. Growth Restriction and Systemic Immune Development in Preterm Piglets. Frontiers in Immunology, Vol. 10, Issue. ,

Wen, Hong Hu, Ying Chen, Lu Zhao, Li and Yang, Xinyun 2020. miR-338-5p Targets Epidermal Growth Factor-Containing Fibulin-Like Extracellular Matrix Protein 1 to Inhibit the Growth and Invasion of Trophoblast Cells in Selective Intrauterine Growth Restriction. Reproductive Sciences, Vol. 27, Issue. 6, p. 1357.

Chon, Andrew H. Ma, Stephen Y. Korst, Lisa M. Chmait, Hikmat R. Purnell, Margaret E. and Chmait, Ramen H. 2021. Antenatal course of referred monochorionic diamniotic twins complicated by selective intrauterine growth restriction (SIUGR) type III. The Journal of Maternal-Fetal & Neonatal Medicine, Vol. 34, Issue. 23, p. 3867.

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Article contents

Perinatal Outcome of Monochorionic Twins With Selective IUGR Compared With Uncomplicated Monochorionic Twins

Abstract

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This article has been cited by the following publications. This list is generated based on data provided by Crossref.

Article contents

Perinatal Outcome of Monochorionic Twins With Selective IUGR Compared With Uncomplicated Monochorionic Twins

Abstract

Keywords

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